Add-On: Autoimmune Reactivity - Array 5
Array 5 is a proprietary multi-antigen immunoassay measuring IgG and IgA reactivity to tissue-specific antigens across thyroid, pancreatic islet, adrenal, gonadal, parietal-cell, myocardial, and connective-tissue targets. It screens for occult or subclinical autoimmunity in patients with multi-system symptoms or high genetic risk, generating hypotheses that require clinical correlation and…
1
Biomarkers
Blood (serum)
Sample
10–14 business days
Turnaround
No
Fasting
What is the Array 5 test?
The Add-On: Autoimmune Reactivity - Array 5 is a multi-antigen immunoassay designed to screen for tissue-specific autoantibodies across a range of organs and systems in a single draw. It is intended as an add-on panel in functional and integrative practice, ordered when the clinician suspects nascent or subclinical autoimmunity that may not yet be captured by standard single-disease antibody tests. The panel's breadth makes it a hypothesis-generating tool rather than a definitive diagnostic: a positive result flags immune reactivity and directs follow-up with organ-specific serology, imaging, and functional assessment. Practitioners order Array 5 to investigate unexplained multi-system symptoms — fatigue, joint pain, thyroid dysfunction, gastrointestinal disturbance, or reproductive abnormalities — where the pattern suggests autoimmune overlap or polyendocrine involvement. It is also used in high-risk individuals with a family history of autoimmune disease, or when early detection might alter management, for example identifying subclinical thyroiditis or islet autoimmunity before frank dysfunction. Because Cyrex arrays report proprietary signal-to-cutoff indices rather than conventional units, results are not interchangeable with disease-specific reference assays and must be interpreted with that limitation in mind.
What does the Array 5 test measure?
Autoantibodies to tissue-specific antigens arise when self-tolerance breaks down, leading the adaptive immune system to generate antibodies against proteins in organs or connective tissue. The Array 5 panel simultaneously screens IgG and IgA reactivity against a defined set of target tissues — typically including thyroid, pancreatic islet, adrenal, ovarian, testicular, parietal cell, myocardial, and connective-tissue antigens, among others. The presence of such antibodies reflects an underlying autoimmune process that may be subclinical or already manifesting as organ dysfunction, and in some cases multiple reactivities coexist, pointing to polyendocrine or systemic autoimmune syndromes.
Detection of tissue-specific autoantibodies helps identify occult autoimmunity before overt disease, supports differential diagnosis in patients with multi-system symptoms, and informs surveillance and early intervention. Because each array result is a panel of individual reactivities, interpretation requires correlation with clinical presentation, family history, and other serological and functional markers. A positive signal does not diagnose a named disease but indicates immune reactivity warranting further investigation.
Why is the Array 5 test ordered?
- Investigation of unexplained multi-system symptoms suggesting polyendocrine or systemic autoimmunity, where single-organ testing has been inconclusive
- Screening of first-degree relatives of patients with autoimmune thyroid disease, type 1 diabetes, or polyendocrine syndromes, aiming to detect subclinical reactivity
- Evaluation of persistent fatigue, joint pain, or cognitive symptoms in the context of other autoimmune markers or high clinical suspicion
- Assessment of reproductive dysfunction — infertility, recurrent pregnancy loss, or ovarian insufficiency — when autoimmune aetiology is considered
- Follow-up of borderline or equivocal results on standard autoimmune panels, to broaden the differential or identify coexisting reactivities
- Monitoring patients with established autoimmune disease who develop new symptoms that may herald a second autoimmune process
- Functional-medicine or integrative practice where early detection of immune dysregulation guides lifestyle, nutraceutical, or pharmaceutical intervention
Sample collection and turnaround
Sample type
Blood (serum)
Fasting required
No
Collection method
Venipuncture at patient service centre
Turnaround
10–14 business days
Collection notes
Phlebotomy required; serum is sent to Cyrex Laboratories. Avoid drawing during or immediately after acute infection or within two to four weeks of immunisation to minimise transient non-specific reactivity. Document all immunosuppressive or immunomodulatory medications, as they may suppress antibody levels.
Specimen requirements
Minimum serum volume per Cyrex protocol (typically 1–2 mL); separate from cells promptly and freeze if shipping is delayed. Reject grossly haemolysed or lipemic specimens. Cyrex provides kit and shipping instructions.
What can affect Array 5 results?
Vaccination and infection can transiently raise non-specific or cross-reactive antibodies through polyclonal B-cell activation and molecular mimicry; delaying the draw until several weeks after acute illness improves specificity.
Corticosteroids, biologics, and disease-modifying agents suppress antibody production, potentially yielding false-negative results; document all immune-active medications and consider timing relative to therapy.
Cyrex arrays use proprietary antigens and thresholds; results are not equivalent to conventional ELISA or immunofluorescence assays for the same target, and between-lot variation can occur.
Haemolysis and lipemia can interfere with optical measurement in immunoassays; grossly abnormal specimens should be rejected and redrawn.
Low-level autoantibodies are occasionally present in healthy people without disease; clinical correlation is essential to distinguish pathological from incidental reactivity.
What do Array 5 results mean?
Elevated
Positive or borderline reactivity (index ≥1.0) for one or more tissue antigens suggests active immune reactivity against that target. Thyroid antibodies may point to Hashimoto thyroiditis or Graves disease; islet antibodies to type 1 diabetes or latent autoimmune diabetes; adrenal antibodies to Addison disease; ovarian/testicular antibodies to autoimmune hypogonadism; parietal-cell antibodies to autoimmune gastritis and pernicious anaemia; myocardial antibodies to myocarditis or post-infectious sequelae. Multiple positive antigens raise suspicion for polyendocrine autoimmune syndromes or systemic connective-tissue disease. Every positive result must be correlated with clinical findings and confirmed with disease-specific gold-standard serology before a diagnosis is assigned.
Normal
Negative results (index <1.0 for all antigens) make significant tissue-specific autoimmunity less likely, though they do not exclude it entirely. Some autoimmune diseases are seronegative or present late in their course with declining antibody titres, and a negative array does not rule out non-antibody-mediated autoimmune processes or other causes of the patient's symptoms.
Reduced
Not applicable — the assay is qualitative/semi-quantitative and reports presence or absence of reactivity. 'Low' or 'negative' is the expected healthy state.
Note: Array 5 is a screening tool with proprietary methodology and thresholds; it is not a diagnostic test and its indices are not interchangeable with conventional disease-specific assays (e.g. TPO, GAD65, 21-hydroxylase). Positive results require clinical correlation and confirmatory testing. Interpretation should account for the pre-test probability, family history, and interfering factors. The panel is offered in functional and integrative settings and is not yet adopted by mainstream endocrinology or rheumatology guidelines; practitioners should frame results as hypothesis-generating and refer onward for definitive investigation when reactivity is detected.
Frequently asked questions
Array 5 simultaneously screens for autoantibodies against multiple tissue-specific antigens — thyroid, pancreatic islet, adrenal, ovarian, testicular, parietal cell, myocardial, and connective tissue — to detect occult autoimmunity in patients with multi-system symptoms or high genetic risk before overt organ dysfunction appears.
How to access the Array 5 test
The Array 5 reference page is free and open to all practitioners. Create a free practitioner account to see pricing, save tests to your list, and generate requisition forms. Verification takes 1–2 business days.
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Published: October 7, 2026
Last reviewed: October 7, 2026
- Husebye ES, et al. Consensus statement on the diagnosis, therapy and follow-up of patients with primary adrenal insufficiency. J Intern Med. (2014)
- American Diabetes Association. Classification and diagnosis of diabetes: Standards of Medical Care in Diabetes. (2023)
- Caturegli P, et al. Autoimmune thyroid diseases. Curr Opin Rheumatol. (2007)
- Kahaly GJ, et al. Polyglandular autoimmune syndromes. Eur J Endocrinol. (2009)
This content is for licensed healthcare practitioners only and does not constitute medical advice. Clinical decisions should be based on the full clinical picture and not on any single test result.